2024 State-Level Accident and Health Insurance Data for the Broader Insurance Industry

September 10, 2025

The U.S. Accident and Health (A&H) insurance industry is vast. It reported nearly $1.4 trillion in premium revenue for 2024, based on filings with the National Association of Insurance Commissioners (NAIC) through the Accident and Health Policy Experience Exhibit (AHPEE), a part of annual financial statements. The A&H insurance exhibit data is available in Mark Farrah Associates’ (MFA’s) Health Coverage Portal™ and allows insurers to analyze and benchmark premiums, claims, lives, member months, and number of policies for multiple accident and health insurance segments, both nationally and by state. MFA has categorized the AHPEE data in the chart below and presents key findings from its analysis of 2024 results.

• Traditionally, when health insurance is discussed, Government programs − Medicare Advantage, Medicare Part D (PDP), Medicare Supplement, Medicaid, and State Children’s Health Insurance Programs (S-CHIP) − are at the forefront of the conversation. This category accounts for the largest share of premium dollars, over $837.2 billion (B) in 2024, up 7.9% from $776.1B in 2023, and covers 112.1 million (M) lives, up 0.9% from 111.1M lives year-over-year. [1]
   
• Government programs and comprehensive Major Medical coverage, comprised of the Federal Employer Health Benefits Program (FEHBP), Group (small, large, and multiple other association & trust segments), and Individual (either purchased directly or through an exchange), are highly regulated – it is no surprise that the medical loss ratios for both categories are 89.2% and 86.6%, respectively.
   
• Non-Comprehensive (Non-Comp) medical insurance, a broad category with 530M enrolled, up from 436M enrolled in 2023, is among the most profitable A&H categories with a loss ratio of 69%. This combination consists of Group and Individual Long- and Short-Term Disability, Long Term Care (LTC), Accident, Named Disease, Limited Benefit, and Student plans. These policies are also among the lowest cost products at $18 per member per month (PMPM).
   
• Ancillary plans, including dental and vision coverage purchased either individually or as part of a group, have a higher loss ratio than Non-Comp medical, 79%, but premiums average $17 PMPM. In 2022, Massachusetts became the first state to enact a Dental Loss Ratio law, requiring dental insurers to spend at least 83% of premiums on patient care. The legislation began impacting Dental insurers in the state on January 1, 2025.
   
• Administrative Services Only (ASO) is the second largest category based on covered lives and includes both Administrative Services Only and Administrative Services Contract type arrangements, as well as other Credit and Stop Loss products. [2]

About the Data

The data used in this analysis brief was obtained from Mark Farrah Associates' (MFA’s) Health Coverage Portal™ database and sourced from insurance companies reporting through the NAIC (National Association of Insurance Commissioners) via the Accident and Health Policy Experience Exhibit (AHPEE). This analysis may exclude a small number of plans that have not yet filed 2024 Annual data. Within MFA’s Health Coverage Portal™, the A&H Policy Experience Exhibit by State table presents summary level data including premiums, claims, lives, member months, and number of policies for multiple health insurance segments, as mentioned above. This table does not include data for plans regulated by the California Department of Managed Health Care (CA DMHC) and not all health insurers are required to file with the state insurance departments. This table presents data for NAIC plans licensed as Fraternal, Life, Property, & Health. MFA’s A&H tables exclude non-health related segments, such as life, property, or flood policies.

In 2021, the AHPEE was modified to provide state insurance regulators with additional data and improve consistency across the annual financial statements. In 2022, all types of insurers were required to report data at the state level, based on the location of the contract. The state-level A&H insurance data first became available in 2022, and MFA’s Health Coverage Portal™ currently includes state-level data for 2022 through 2024. Historically, this information was only available based on the domicile of the insurer; the AHPEEs prior to 2022 are available but not directly comparable with more recent data.

About Mark Farrah Associates (MFA)

Mark Farrah Associates (MFA) is a leading data aggregator and publisher providing health plan market data and analysis tools for the healthcare industry. Our product portfolio includes Health Coverage Portal™, County Health Coverage™, 5500 Employer Health ^plus, Medicare Business Online™, Medicare Benefits Analyzer™, and Health Plans USA™. For more information about these products, refer to the informational videos and brochures available under the Our Products section of the website or call 724-338-4100.

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